What is osteoporosis?

Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

  Bone is living tissue, which is constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone doesn't keep up with the removal of old bone.

  Osteoporosis affects men and women of all races. But white and Asian women — especially those who are past menopause — are at highest risk. Medications, dietary supplements and weight-bearing exercise can help strengthen your bones.


How can you prevent Osteoporosis?

  • Exercise has been shown to be beneficial in the treatment of Osteoporosis
  • If you have Osteoporosis, you might mistakenly think exercise will lead to fracture. In fact, though, using your muscles helps protect your bones.
  • Osteoporosis is a major cause of disability in older women. So if you have osteoporosis, you reduce your risk of the spinal problems and broken bones that can result in loss of mobility and independence thru exercise
  • It is never to late to start exercising for the purpose of preventing osteoporosis. After menopause, the pace of bone loss really picks up. Starting an exercise program even at this age can increase your muscle strength, improve your balance and help you avoid falls — and it may keep your bones from getting weaker.

What is the prognosis of osteoporosis?

For postmenopausal women, regular physical activity can increase muscle strength, improve balance, and make you more capable physically, your posture will be better maintained, you will experience less pain and most importantly you will have a better sense of well being and enjoy your life more. Exercising, if you have osteoporosis means finding the safest, most enjoyable activities for you, given your overall health and amount of bone loss. Your physiotherapist and doctor can work together to determine the best program for you.


What should you do before you Start?

Before you start you may want to consult with your doctor to determine your bone density. If you have symptoms of pain your physiotherapist will perform a musculoskeletal examination and treat with the goal of pain relief. As pain improves, your physiotherapist will perform a functional movement screen that looks at your balance and stability and strength endurance and some of the essential movement skills for daily living and also for an activity based lifestyle. This information in addition to our previous orthopaedic assessment findings will allow us to develop a personal improvement plan just for you. The focus will be bone strength and muscle strength, fall prevention and balance training.


How can physiotherapy and massage therapy help osteoporosis?

If you've always been physically active, that’s great. Even though your bones may lose some density as you age, they're less likely to become brittle enough to break if you slip and fall when you have been active. In addition, exercising strengthens your muscles and that also protects your bones.

  Physiotherapists are trained to prescribe safe and effective exercises and with Osteoporosis your goal is to:

  • Strength. Develop and maintain physical strength in your legs and hips. That means that in your personal improvement plan, incorporate efforts that are challenging for you do so that the muscles can adapt and develop strength. Strength requires local muscle energy stores to perform the effort, rather than energy that is brought to the muscle via the cardiovascular system. In order to develop strength there must be a greater challenge and force generation than it is to develop endurance.
  • Endurance. Develop cardiovascular and muscle endurance. That means that you need to develop and maintain the ability to repeat movements skills over and over again and this requires your heart/lungs to repeat efforts, and your muscles to repeat efforts. Endurance requires the use of sustainable energy systems that are brought from your circulatory system. Once you can perform one sit to stand “squat”, repeat it 10, 20, 30, 40 and 50 times. No arms, hands in the air …. You are on your way to the Podium!
  • Strength Endurance. Putting together your ability to perform just a few repetitions (strength) and the ability to repeat submaximal efforts (endurance) should be your ultimate goal. For example, if you are only physically capable of getting up from the chair and back down once, that’s ok. You can take a rest and try again and again and before you know it you will have increased your strength as well as your endurance despite how hard if may have felt. This is the art of training and development and your physiotherapist can help you with this if you are unable to progress on your own.
  • Balance. Fall Prevention is Critical. Develop and maintain coordination and balance and means that you have to develop physical and functional skills if you don’t already have them and you have to use these skills daily. Can you walk and change directions over and over again without hesitation? Can you perform 50 sit to stand movements at a time, call them squats if you will but they are really the functional skill of get up and down.
  • Mobility. Flexibility is important but do not confuse this with mobility. Mobility it integrates flexibility, strength, endurance and balance.
  • Flexibility. Although flexibility alone will not prevent the risks of osteoporosis, good hip, knee and ankle flexibility will allow you to develop and maintain better functional skill and that is the key.
  • Agility. In the athletic sense agility is the ability to go all out and change direction. This skill, taken down a notch or two to the level of Osteoporosis training means the same, to be able to go all out, lifting your groceries and climbing thru a snow bank and change direction without falling and while maintaining your balance and coordination in a safe environment. Of course this will depend on where you fall on the spectrum of bone density and also where you fall on the spectrum of supervision but it is never to late to exercise and to develop better skill.

How can exercise and physical development help osteoporosis?

What are the best activities to prevent Osteoporosis?

The best exercises are those that develop core and trunk strength as well as hip and leg strength, they should be weight bearing aerobic activities that encourage flexibility, stability and balance.  
  • Strength training. Strength training includes the use of free weights, weight machines, resistance bands to strengthen the muscles and bones in your arms, legs and upper spine. Strength training can also work directly on your bones to slow mineral loss. Exercises that gently stretch your chest muscles; strengthen the muscles between your shoulder blades and improve your posture can all help to reduce harmful stress on your bones and maintain bone density. This kind of program is designed to prevent the severe osteoporotic compression fractures that may occur in your spinal column. These fractures often lead to a stooped posture and in increasing the pressure along the front of your spinal column, and result in even more compression fractures.
  • Weight-bearing aerobic activities. Weight-bearing aerobic activities involve doing aerobic exercise on your feet, with your bones supporting your weight. Examples include walking, dancing, low-impact aerobics, stair climbing, gardening and to a lesser effect elliptical training machines. These types of exercise work directly on the bones in your legs, hips and lower spine to slow mineral loss. They can also provide cardiovascular benefits, which boost heart and circulatory system health. Swimming and water aerobics, although beneficial to improved cardiovascular fitness, does not have the impact your bones the way that is needed to slow mineral loss.
  • Flexibility exercises. Being able to move your joints through their full range of motion helps you maintain good balance and prevent muscle injury. Increased flexibility can also help improve your posture. When your joints are stiff, your abdominal and chest muscles become tight, pulling you forward and giving you a stooped posture. Your physiotherapist can teach you the postural exercises that will prevent this process along with minimizing your poor sitting postures and staying active. Stretches are best performed after your muscles are warmed up — at the end of your exercise session, for example. They should be done gently and slowly, without bouncing. Avoid stretches that flex your spine or cause you to bend at the waist. These positions may put excessive stress on the bones in your spine (vertebrae), placing you at greater risk of a compression fracture. Ask your physiotherapist which stretching exercises would be best for you.
  • Stability and balance exercises. Fall prevention is important for people who have osteoporosis. Stability and balance exercises help your muscles work together in a way that helps keep you more stable and less likely to fall. Simple exercises such as standing on one leg or movement-based exercises such as tai chi can improve your stability and balance.
  If you're not sure how healthy your bones are, talk to your doctor. Don't let fear of fractures keep you from having fun and being active.

How can low intensity laser therapy help osteoporosis?

Low Intensity Laser Therapy (LILT) is the use of monochromatic light. Meditech Bioflex has been producing this technology for 20 years and has an extensive in house clinical lab.

  The light source is placed in contact with the skin allowing the photon energy to penetrate tissue, where it interacts with various intracellular biomolecules resulting in the restoration of normal cell morphology and function. This process also enhances the body's natural healing propensities.

  Low Intensity Laser Therapy does not heat or cut tissue. Unlike many pharmacological treatments that mask pain or only address the symptoms of the disease, Laser Therapy treats the underlying condition or pathology to promote healing. The technology utilizes superluminous laser diodes to irradiate diseased or traumatized tissue with photons. These particles of energy are selectively absorbed by the cell membrane and intracellular molecules, resulting in the initiation of a cascade of complex physiological reactions, leading to the restoration of normal cell structure and function.

  The process is curative and therefore results in the elimination of symptoms including pain. In addition, it enhances the body’s immune system response and facilitates natural healing. The therapy is completely safe and has no adverse side effects. The technology is highly effective in the treatment of musculoskeletal conditions, arthritis, sports injuries, wound healing and a wide range of dermatological conditions. Whiplash injury typically involves injury to muscles, ligaments, and joints and typically involve several levels and a more wide spread area of injury due to the force full nature of the injury. Muscles of the neck, although short, cross over several joints and so the discomfort is generally more global initially. Laser therapy directed by multiple diodes are able to reach these tissues.


Physiological effects of Low Intensity Laser Therapy

With LILT there is an increased production and release of:  
  • Endorphins which - natural analgesics
  • Cortisol – a precursor of cortisone
  • Growth hormone – instrumental in tissue repair
  • ATP – improves and regulates cellular metabolism
  • An increase in protein synthesis – collagen, DNA, fibroblasts
  • A facilitated venous and lymphatic flow
  • Increased angiogenesis – the elevation of oxygen saturation
  • Enhanced immune response
  These responses are some of the many processes that accelerate cellular regeneration (cartilage, epithelium) and restore normal cell morphology and function. Treatments are typically 25 minutes to over 1 hour depending on the condition and area being treated   The most popular technical / clinical information requested is available on the Meditech website under Laser Reports. You may visit the Meditech website research section directly for detailed abstracts, case profiles and articles on a variety of topics relating to the use of low intensity laser therapy in the treatment of various medical conditions.  

What life style and self-care measures can you do for yourself to reduce your risk of osteoporosis?

  • Exercise, Exercise, Exercise
  • Don't smoke. Smoking increases bone loss, perhaps by decreasing the amount of estrogen a woman's body makes and by reducing the absorption of calcium in your intestine.
  • Avoid excessive alcohol. Consuming more than one alcoholic drink a day may decrease bone formation and reduce your body's ability to absorb calcium. Being under the influence also can increase your risk of falling.
  • Shoes. Wear low-heeled shoes with nonslip soles and check your house for electrical cords, area rugs and slippery surfaces that might cause you to trip or fall. Keep rooms brightly lit, install grab bars just inside and outside your shower door, and make sure you can get in and out of your bed easily.
  • Avoid High-impact exercises, such as jumping, running or jogging. These activities increase compression in your spine and lower extremities and can lead to fractures in weakened bones. Avoid jerky, rapid movements in general. Choose exercises with slow, controlled movements.
  • Exercises in which you bend forward and twist your waist, such as touching your toes or doing sit-ups. These movements put pressure on the bones in your spine, increasing your risk of compression fractures. Other activities that may require you to bend or twist forcefully at the waist are golf, tennis, bowling and some yoga poses.

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